Prior research has demonstrated an important link between relationship intimacy and condom use. Limited research has been conducted on this connection within the realm of female sex work. We examined the association between perceived relationship intimacy and consistent condom use among 258 female sex workers and 278 male regular paying partners who participated in a cross-sectional survey in the Dominican Republic. In multivariate analysis, higher intimacy among sex workers and regular paying partners was negatively associated with consistent condom use. Among those reporting higher perceived intimacy, male participants were more than twice as likely to report consistent condom use as female participants. Female sex workers in relationships of higher perceived intimacy are at greater risk of HIV/AIDS than their male regular paying partners. Gender-sensitive HIV prevention programs are needed to address the differential influence of relationship intimacy on condom use in the context of sex work.